When a patient seeks healthcare services from a healthcare provider, various processes may be performed between the time when patient data is received and when healthcare services are provided. The various processes may make up a patient access workflow and may include such processes as, but are not limited to, finding coverages (e.g., insurance eligibility and verification), verifying demographic data to help ensure that a patient's demographic data is correct for insurance claims, billing statements, etc., checking payer compliance to help screen for payer medical necessity and precertification and to aid with accuracy in orders, coding and billing, estimating a payment amount, determining a patient's financial situation to help mitigate the risk of late payments and possible need for collections later on, and collecting payment for services.
Currently, the patient access workflow is a fragmented process, wherein various tools may be utilized for different processes. For example, one tool may be utilized for verifying patient demographic information, another tool may be used for checking payer policies, another tool may be used for determining financial eligibility, another tool may be used for determining a best payment method, another tool may be used for payment processing, etc.
As can be appreciated, a fragmented patient access workflow process can be inefficient and can lead to errors. It is with respect to these and other considerations that the present invention has been made.